Breast cancer affects nearly one in eight American women. For women, it is clearly their most feared disease. More than 175,000 women will learn this year that they have breast cancer, and 95% of them will be over 40. The good news is that if detected early, 97% of these women will survive at least 5 years. Dr. Donnica offers tips to improving your monthly breast self exam. Start by doing it properly and routinely! For a visual interactive of how to do a proper breast self exam, click here.

What is Breast Self Exam?

Breast self exam (BSE) is an important tool (but not the only tool!) to detect potentially malignant breast masses early. Ideally, it should be done once per month, a week after your period, in all women over age 18. This includes women who are 90, women who are on birth control pills, women who are pregnant, and women who are nursing. ALL WOMEN.

There are many excellent guides to properly performing a BSE. Like anything else, it takes practice. First, get into a comfortable position, lying, sitting or standing (some women like to do this in the shower). Use the pads of your fingers. Start from the nipple, with one hand on the opposite breast. Move your fingers in a circular fashion and continue into the armpit ("axilla"). Press firmly, particularly in the armpit area. Repeat with the opposite breast. Be sure to gently press your areolar area (the colored area around the nipple) and then squeeze the nipple itself. Here you are feeling for lumps or abnormalities as well as looking for a discharge. You should also examine the appearance of your breasts in the mirror. Take your time. Minimize distractions.

The frustration I hear from many women is that they hear a lot in the media or from their health care providers about how to do a BSE, but they don't really know what they're looking for! The key is to get familiar with what your breasts feel like normally. Any change (so long as this is at the same time in your menstrual cycle) is worth noting, and worth reporting to your physician. While some changes may be scary, the good news is that most breast problems are benign. These include breast pain (mastalgia), infection (mastitis), fibrocystic breasts (the lumpy/bumpies), fibroadenomas, and nipple discharge.

More than half of all premenopausal women (63%) have "lumpy" or "fibrocystic" breasts. If you are one of them, you want to beware of new lumps and changes in existing lumps such as increasing size, changing shape, or decreased mobility. Painful lumps are not usually of concern as far as cancer, but may indicate other changes and should be reported to your physician. Thickening in the skin is also a concern: we call this "orange peel" skin. Feeling anything such as small BB pellets or anything like a dried out pea is of serious concern. Many lumps are much deeper than most patients are feeling. . .push firmly and push the tissue between your two fingers.